Funds Exam 5 Ch 7, 31, 33, 34 ; Cardio and Respiratory Assessment
The parents of a 10-month-old infant with a cold ask the nurse about the use of honey to alleviate a cough. What is the nurse's best response?
"Honey should not be given to children under the age of 1 year"
When should the nurse begin discharge planning for a client?
During the admission assessment
Which nursing theorist views health as an expression of living energy available to an individual, displayed as a continuum with high energy (wellness) at one end and low energy (illness) at the opposite end?
Energy
Broadening the type of people one enjoys and seeing commonalities will help one to recognize and appreciate the suffering in the unique experience of one person
Enjoying
The nurse enters the room of a client who is receiving oxygen at 4 L/min via nasal cannula. What actions should the nurse take to prevent complications? Select all that apply.
Ensure the pt keeps nasal prongs in the nares Assess the nares for excessive dryness Pad the oxygen tubing behind the ears
Identify the five stages of illness behavior that individuals move through as they cope with disruptions in health.
Experiencing symptoms Sick role behavior Seeking professional care Dependence on others Recovery
When educating student nurses on self-care and sleep hygiene, what information should be included? Select all that apply.
Fatigue can cause impaired judgment and decision making If possible, take frequent breaks during the night shift Be smart about your caffeine use Plan rest days in between consecutive workout days
What is an example of something that causes coping skills to be altered?
Financial burdens Family stress
A client has been having difficulty falling and staying asleep and is feeling unrested during the day. Which action would best assess the situation?
Have the pt complete a sleep diary for 14 days
The nurse is caring for a client in the intensive care unit with fluid volume overload related to congestive heart failure who is receiving diuretics. Which factors can lead to altered sleep patterns for this client? Select all that apply.
Hospitalization in an ICU Frequent urination related to diuretic use Repeated interruptions throughout the day and night
PICOT Intervention component
I
Identifying a pt's main concern is an important component of the assessment communication process
Identifying
In which sleep stage would a client's EEG show beta waves?
In periods of wakefulness
The nurse is caring for a client admitted with uncontrolled type 2 diabetes mellitus. Which instruction should the nurse provide to the client to move them to the health aspect of the health-illness continuum?
Include fresh fruits and vegetables in the diet
What are reasons why clients are noncompliant with recommended care plans? Select all that apply.
Inconvenience Lack of effort Pain associated with therapy
Which statement best describes parasomnia?
Parasomnia is a pattern of waking behavior that involves sleepingwalking
What factors influence the health-illness continuum? Select all that apply.
Personal perceptions Genetic makeup Gender Age
The nurse is developing a plan of care for a client who just had a chest tube inserted. Which emergency supplies should the nurse keep at the client's bedside? Select all that apply.
Petroleum gauze Rubber-tipped clamps Spare disposable drainage system
The parents of a toddler report difficulty getting their child to sleep at night. The child wants to play and not go to sleep. Which action suggested by the nurse would be most effective?
Plan sedentary activities the last hour before bed
The nurse is caring for a client who is admitted for the third time in 6 months for uncontrolled diabetes mellitus. When assessing the causative and contributing factors of these exacerbations, what should the nurse ask first?
"Do you have financial difficulty affording the blood glucose meter supplies and a healthy diet?"
The nurse is discussing sleep patterns with a client who reports sleep disturbances. Which questions should the nurse ask the client to determine the cause of the sleep problem? Select all that apply.
"Do you include exercise in your daily life?" "What is a typical 24 hour food intake for you?" "How many caffeinated beverages do you drink each day?"
A nurse is caring for a client with peripheral neuropathy secondary to uncontrolled diabetes, which is causing difficulty sleeping, daytime drowsiness, irritability, and restlessness. The client does not want to take medication for pain but is willing to try alternative therapies. The nurse suggests acupuncture. What component of the PICOT model addresses acupuncture in this situation?
"I"
Focusing on what the pt or family has to say instead of thinking ahead to what the nurse wants to ask next
Attuning
Which are causes of obstructive sleep apnea (OSA)? Select all that apply.
Being overweight Enlarged tonsils Deviated nasal septum
Which high-frequency, low-amplitude brain waves are found during wakefulness?
Beta
What are examples of unknown factors that cause a disruption in health? Select all that apply.
Bringing a new baby home from the hospital A physical defect found on ultrasound of a fetus Injuries from a car accident
PICOT Addresses the compare group
C
The nurse is educating a client with a new diagnosis of sleep apnea regarding consistent use of the continuous positive airway pressure (CPAP) machine. Which complications should the nurse instruct the client about that can occur with untreated sleep apnea? Select all that apply.
Cardiovascular diseases Diabetes
The nurse is discussing the dangers of alcohol consumption with a client who reports consuming four to six beers per day. What information about alcohol consumption can the nurse provide to the client?
Causes cirrhotic liver disease Leads to malnutrition Contributes to half of motor vehicle accidents
Identify the examples of acute illness. Select all that apply.
Cholecystitis Pyelonephritis Appendicitis
Which examples would be considered health disruptions? Select all that apply.
Competing demands of life Loss of a spouse Bipolar disorder Fibromyalgia
A client has been moved to an assisted living facility by her family due to declining health and inability to care for herself. The nursing staff notices she is having a hard time adjusting and appears to be confused and depressed. What can be suggested by the nurse?
Create an area in her room with pictures and other items from home to brighten her environment, making it feel more like her space
What typically manifests as a rough, barking sound that is not high-pitched?
Croup
Which cultural considerations should the nurse include for all clients?
Culutral influences on responses to illnesses Cultural influences on health decisions and behaviors
What can cause a client to abandon normal coping skills during illness?
Dealing with the cumulative effect of illness and other life disruptions
A nurse is admitting a client with a myocardial infarction. Which nursing diagnosis is the highest priority?
Decreased cardiac output
Waves that are more prominent during wakefulness
Delta
Which low-frequency, high-amplitude regular waves are found in deep sleep but are not common in children and rare in adults?
Delta
A client has had COPD and emphysema for many years and continues to work and support the family. Because of oxygen dependency, the client must quit work, and the partner will have to begin a new job and support the family. The client states, "I would be better off dead." Which action should the nurse take?
Develop a care plan for the family
The nurse is caring for an older adult client admitted to the hospital for abdominal surgery and develops a plan of care to prevent respiratory complications. Which factors would lead the nurse to develop this plan of care? Select all that apply.
Difficulty coughing up secretions Diminished diaphragmatic function
The nurse is educating a group of high school students about the hazards of tobacco use. Which information about tobacco use can the nurse include during this session?
Increases risk for cancer Leads to low-birth-weight babies
The nurse is educating a group of teenagers regarding obtaining sufficient amounts of sleep. Which consequences of sleep deprivation should the nurse include in the presentation? Select all that apply.
Increases sensitivity to pain Intensifies insulin resistance Increases the appetite and intake
Which factors can move a client to the illness end of the health-illness continuum?
Injuries Mental disorders Physical ailments Hospitalization
When a person has difficulty falling asleep at night
Insomnia
Which is the best action when building trust in an elderly client who has been admitted to an emergency facility?
Introduce oneself to the pt and explain one's role
In which ways does hardiness impact health? Select all that apply.
It allows for a positive attitude toward change It provides a strong positive force to live It leads to longer life It promotes the use of spiritual resources
How can telehealth be beneficial to healthcare?
It allows the client to be empowered for self-management
Which activities would help a client reduce the risk for developing chronic disease?
Jogging for 15 minutes most days Walking on a daily basis Gardening for 30 minutes a few days per week
What is the hormone that naturally controls sleep?
Melatonin
The nurse is working with a client newly diagnosed with narcolepsy. Which treatment regimen would the nurse expect to be prescribed for this client?
Methylphenidate (Ritalin)
Which changes can be noted during the deepest stage of nonREM sleep? Select all that apply.
Muscles relax Heart rate lowers Respirations decrease
When a person falls asleep suddenly when standing up
Narcolepsy
Usually occur in children when they wake up and thrash about and hallucinate
Night terrors
Which sleep disorder involves a person suddenly waking up thrashing about and hallucinating?
Night terrors
Which mask is this?
Nonrebreather mask
An individual who is ill, whose needs are met by a healthcare facility, and who has access to appropriate medications, diet, and healthcare instruction falls into what area of Dunn's wellness grid?
Protected poor health in a favorable environment
The postsurgical client on the medical-surgical unit has suffered a stroke and is now being transferred to the ICU. How can the nurse assigned to this client help make this transition as easy as possible on the family? Select all that apply.
Provide for teaching needs Ensure safety and comfort Communicate with the new unit
The nurse is caring for a client experiencing pain and is concerned about the client's oxygenation. Why is this concerning to the nurse?
Pts in pain tend to breathe shallowly, which increases the risk for atelectasis
In which ways can the nurse incorporate a client's environment into a health and wellness plan?
Recommending a walk by a pond Suggesting a picnic in a local park
What priority action should the nurse take to promote sleep for a hospitalized client?
Schedule nursing care to avoid interrupting sleep
Which neurotransmitters are related to excitatory and inhibitory sleep mechanisms? Select all that apply.
Serotonin Histamine Prostaglandins Acetylcholine
The nurse is developing a plan of care for the stressed partner and caregiver of a client with dementia. What should be considered when establishing the goals?
Set goals with acceptable steps that are realistic
The nurses initial approach to a pt creates an atmosphere that determines the type of communication that takes place
Settling in
A client is brought into the emergency department after being found nonresponsive on the sidewalk outside a liquor store. The client appears to be disheveled with a foul body odor, has an extremely low body weight, and is experiencing pain. The triage nurse assumes the client is homeless and a drug user, quickly takes the vital signs without speaking to them, and gives only short answers to their questions. What aspect of communication has this nurse not engaged in? Select all that apply.
Settling in Acceptance Attuning Enjoying
Which mask delivers 40 to 60% Fio2 on 5 to 10 L/minute?
Simple mask
Which mask is this?
Simple mask
What becomes slower during sleep?
Spindle fibers
PICOT Refers to an expected time frame if needed
T
What is the fundamental concept of Neuman's continuum of health? Select all that apply.
The more energy generated than expended, the healthier an individual will be When energy output exceeds input, illness occurs
Which statement best describes "lived experience" in healthcare?
The uniqueness of how a pt experiences disruptions in health
Waves that slow down when the pt sleeps
Theta
Which high-amplitude brain waves found during deep sleep are common in children but rare in adults?
Theta
A client is experiencing depression with secondary insomnia. What type of medication could be prescribed for this client?
Tricyclic antidepressant
The nurse is caring for a postoperative client with an oxygen saturation of 90% who has fine crackles in both lung bases. Which action should the nurse take?
Use an incentive spirometer
Which concept involves the movement of air in and out of the lungs through the act of breathing?
Ventilation
Which mask delivers 24 to 50% Fio2 on oxygen?
Venturi mask
Which mask is this?
Venturi mask
Based on what has been learned about personal relationships and health status, which families would experience higher levels of wellness? Select all that apply.
Views the family as capable and successful Teaches good negotiation skills, builds a network of family support, while encouraging the development of independence Encourages open communication and works through disagreements
The nurse is preparing to give a client a back massage to promote rest and sleep. Place the steps in sequential order.
Warm the lotion and place in your hands Place your hands on either side of the spine and use gentle and continuous pressure while moving hands down the spine and up the distal side of the back Work thumbs on the areas of tightness Evaluate the pt's level of comfort and relaxation
A client is asking for medication for trouble falling asleep and staying asleep. The client also feels groggy and unrested during the day. What should the nurse assess for as possible etiologies? Select all that apply.
Watching tv while in bed Sleeping with smartphone nearby Caffeine consumption Current medications
When assessing a client for sleep disturbances, what is an appropriate question to address the sleeping environment?
What room temperature do you prefer?
A client presents to the clinic requesting medication to help with sleep. The healthcare provider diagnoses the client with insomnia. Which criteria would the nurse expect to be present related to this diagnosis? Select all that apply.
Happens 3 days per week Happens for at least 3 months
The nurse is preparing to interview a client with an extensive cardiac history. Which questions would the nurse ask of a client in a focused assessment of the family history? Select all that apply.
Have any of your siblings experienced a heart attack or stroke? Did your father or brother develop coronary artery disease before the age of 55? Did your mother or sister develop coronary artery disease before the age of 65?
What occurs when the body breathes rapidly, causing too much CO2 to be removed from the alveoli?
Hyperventilation
What occurs when the body breathes too slowly, or shallow breathing, which does not allow enough O2 to reach the alveoli?
Hypoventiation
A nurse is teaching a client how to promote venous circulation. Which statements by the client indicates understanding of the teaching? Select all that apply.
I will keep my legs elevated when I am sitting in the recliner I will take a walk around the block in the morning and the afternoon I will drink at least six 8-ounce glasses of water every day I will attend a smoking-cessation class at the YMCA
A client presents to the clinic with a cough. What should the nurse include in the assessment? Select all that apply.
If it is dry, productive, or hacking When it occurs How long the pt has had cough What makes it worse or better
How do positive inotropes affect CHF pts?
Increase cardiac contractility
Which finding would the nurse expect when assessing a client with right-sided heart failure?
Peripheral edema
Which finding would the nurse expect when assessing a client with pulmonary edema?
Pink and frothy sputum
What nursing action should be used for a client with pneumonia of the right lower lobe?
Place the pt on the left side and elevate the foot of the bed
The vascular system is composed of three types of vessels. What are capillaries?
Microscopic vessels that connect the arterial and venous systems
Which symptoms would the nurse expect to find in a female client experiencing a heart attack? Select all that apply.
Nausea Jaw pain Shortness of breath
Which dilate the vessels during an episode of chest pain?
Nitrates
Which mask delivers 70 to 100% Fio2 on 6 to 15 L/minute?
Nonrebreather mask
PICOT Refers to the outcome, which addresses the ultimate goal of no pain
O
PICOT Addresses the population/client
P
Which part of the ECG complex represents the SA node firing and conducting the impulse through the atria?
P wave
Which situations lead to a secondary cause for sleep disorders? Select all that apply.
Pain Depression Hyperthyroidism
The nurse is educating a group of teenagers about the physical damage that occurs from tobacco smoke. What should the nurse include in the teaching session? Select all that apply.
Paralyzes cilia Leads to lung cancer Increases mucus production Causes bronchial inflammation
The nurse receives the arterial blood gas values for a client with pneumonia. Which finding requires additional action?
Pco2 level 65 mm Hg
A nurse is assessing a client with cardiac pain. What is the difference between cardiac pain and pleuritic pain? Select all that apply.
Pleuritic pain is unrelieved with nitrates Cardiac pain includes radiation to the left arm, nausea, dyspnea, fatigue, and anxiety Cardiac pain typically does not change with inhalation or exhalation
What should the nurse include in the assessment of a client admitted with a diagnosis of community-acquired pneumonia? Select all that apply.
Presence of cough Amount and color of sputum Occurence of fever
The nurse is providing tuberculin testing at a community-health program. Which factors should the nurse assess during the prevaccination screening? Select all that apply.
Prior exposure to tuberculosis Country of birth and recent travel Employment in a healthcare setting
Which part of the ECG represents ventricular depolarization and causes the ventricles to contract?
QRS complex
How do diuretics affect CHF pts?
Reduce the volume of circulating blood and prevent accumulation of fluid in the pulmonary circulation
Which instructions are most important for the nurse to provide a client when using portable oxygen tanks in the home setting?
Refrain from any smoking in the home Store oxygen tanks in an upright position
A nurse is reviewing the ECG complex of a client post-myocardial infarction (MI). What is the U wave?
Represents an electrolyte imbalance and is not usually seen
A nurse is reviewing the ECG complex of a client post-myocardial infarction (MI). What is the P wave?
Represents the firing of the SA node and ocnduction of the impulse through the atria
A nurse is reviewing the ECG complex of a client post-myocardial infarction (MI). What is the T wave?
Represents the return of the ventricles to an electrical resting state so they can be stimulated again
A nurse is reviewing the ECG complex of a client post-myocardial infarction (MI). What is the QRS complex?
Represents ventricular depolarization and leads to ventricular contraction
Premature babies are at higher risk for what respiratory problem?
Respiratory distress syndrome (RDS)
The NHLBI panel of experts recommended that children between 9 and 11 years be screened for cardiovascular risk factors. What is the most important screening for this age group?
Select lipid profile
Which finding would the nurse expect when assessing a client with left-sided heart failure?
Shortness of breath Decreased urinary output Crackles in the lung fields
Occurs when a person stops breathing during sleep
Sleep apnea
An adolescent reports constant fatigue and an inability to stay awake in school. Which factors should the nurse assess for that could be interfering with sleep? Select all that apply.
Smartphone use Drug and alcohol use Caffeine consumption Schoolwork and studying
The nurse is examining a client who reports a history of peripheral venous abnormalities. What would the nurse expect to find during the examination? Select all that apply.
Stasis ulcers Lower etremity edema Brown skin discolaration
There are various cardiovascular medications that lower cholesterol. Which medication category lowers LDL cholesterol levels?
Statins
Which are a class of drugs that protect against coronary artery disease by lowering triglycerides and reducing the production of cholesterol by the liver?
Statins
What is the most common cause of infectious pharyngitis?
Streptococcal pyogenes
Cardiac dysrhythmias that occur above the ventricles
Supraventricular
Which part of the ECG represents the ventricles return to a resting state?
T wave
In which ways can anxiety interfere with a client having a restful night's sleep? Select all that apply.
Tachycardia Increased respirations Increased gastric secretions
Pt with a respiratory rate higher than 24 breaths per minute is _________?
Tachypneic
Which factors can affect older adults' ability to obtain adequate sleep at night? Select all that apply.
Taking longer to fall asleep Awakening for longer periods during the night Nocturia interfering with sleep
Gas exchange that occurs in the alveoli-capillary membrane is referred to as what type of respiration?
External
Normal fasting serum glucose?
70-100 mg/dL
Normal CRP?
<1 mg/dL
Normal total cholesterol level?
<200 mg/dL
A nurse is learning about coronary artery disease. Which description is best?
A condition where plaque builds up in the arteries that is a leading cause of cardiac ischemia
A client is in the emergency room experiencing chest pain and dyspnea. What would be the most important assessment data to report to the healthcare provider?
A pulse oximetry reading of 91% on room air
A nurse is reviewing lab data on a client with a BMI of 30.2 (obesity). What lab value would be most concerning?
A total cholesterol level of 289 mg/dL
Place in order the stages of illness behavior that an example client experiences, according to Suchman.
Feeling a runny nose and a cough Staying home from work Going to a doctor's appointment Having a prescription filled and staying in bed per doctor's orders Returning to work once symptoms subside
Which hormone is released during sleep?
Growth hormone
Which causes vessel dilation?
ACE inhibitors
A nurse is teaching a group of clients about different cardiovascular medications. Which cardiac medications are considered vasodilators? Select all that apply.
ACE inhibitors Angiotensin II receptor blockers Nitrates
Acceptance of appearance, lifestyles, ways of coping, and values is instrumental in effective communication. The nurse can accept people as valued unique individuals, despite differences
Acceptance
The nurse is caring for a 65-year-old female client recently diagnosed with breast cancer. According to Neuman's health-illness continuum, which factors could have contributed to this illness?
Age Gender Genetics
A client with restless leg syndrome reports difficulty sleeping. Which factors may be the cause? Select all that apply.
Age Low iron levels Antidepressants
An individual begins gasping for air and makes an unusual high-pitched, harsh, crowing sound. What could be occurring?
Airway obstruction
The nurse has been alerted that a special needs client is about to be admitted from the residential facility. What would be an appropriate way to alleviate anxiety and ease the transition?
Allow more time for the admissions process if preadmission cannot be arranged
The nurse is reviewing electroencephalograph results for a client who reports sleep difficulty. Which waves would the nurse expect to appear when the client is drowsy?
Alpha
Waves that appear when a pt is drowsy and begins to fall asleep
Alpha
Which medium-frequency, low-aimplitude brain waves are found during the drowsy stage?
Alpha
A client with a diagnosis of dysrhythmias questions the nurse about the need for so many medications. The nurse explains the need for an antiarrhythmic to regulate the heart rate and rhythm. Which complications should the nurse explain to the client that can occur with untreated dysrhythmias? Select all that apply.
Amplified risk of stroke Decreased tissue oxygenation
Which statement is accurate regarding electrocardiography (ECG)?
An ECG reflects what the nerves tell the heart muscle to do
What does the U wave represent?
An electrolyte imbalance Not usually seen
Which relax blood vessels, decrease blood pressure, and ease workload of the heart?
Angiotensin II receptor blockers
Place the steps for performing a tracheostomy or endotracheal suctioning in order.
Assess the pts respiratory status position in semi-Fowler's and place linen-saver padding on the pts chest Don face shield/goggles and turn on suction using the lowest pressure Don nonsterile gloves and test the suction Remove and discard gloves; then open the suction catheter kit Don gloves. Pour sterile saline into the sterile container Premeasure the catheter insertion distance Don sterile gloves. Attach the suction catheter to the connection tubing Placing the tip of the catheter in the sterile saline, suction a small amount of solution through the catheter Lubricate the suction catheter tip with normal saline Gently and quickly insert the suction catheter into tubing and apply suctioning Perform hand hygiene, then perform mouth care for the pt
Place the sequence of mechanical movement through the heart as represented on the ECG in the correct order.
Atrial contraction Ventricular depolarization Ventricular repolarization
A nurse is assessing an older client for orthostatic hypotension. What receptors would respond to a client's lowering blood pressures?
Baroreceptors
Which are located in the heart walls of the heart and blood vessels and are sensitive to pressure changes?
Baroreceptors
What is used to treat angina, acute MI, and CHF?
Beta-adrenergic agents
Which medications should the nurse anticipate will be prescribed for a client experiencing worsening congestive heart failure? Select all that apply.
Beta-adrenergic agents Diuretics Positive inotropes
Which blocks the stimulation of beta receptors, which are located in the heart, to decrease heart rate, slow conduction of the AV node, and reduce myocardial contractility?
Beta-adrenergic blockers
Pt with a respiratory rate of less than 10 breaths per minute is _________?
Bradypneic
A nurse is preparing to perform a focused respiratory assessment. What should be included? Select all that apply.
Breathing rate Body position Breath sounds Use of accessory muscles
The nurse is considering actions to promote relaxation and sleep for an anxious client. Which actions could the nurse consider teaching? Select all that apply.
Guided imagery Music therapy Progressive muscle relaxation
Which are located in the aortic arch and carotid arteries and are sensitive to chemicals in the blood pH, oxygen, and carbon dioxide?
Chemoreceptors
What would the nurse assess for in a client with stable angina? Select all that apply.
Chest pain relieved by rest Chest pain caused by cigarette smoking
What would the nurse assess for in a client with unstable angina? Select all that apply.
Chest pain unrelieved by medication Chest pain that gets worse without relief Chest pain that leads to a MI
The nurse is examining a client who reports a history of peripheral arterial disease. What would the nurse expect to find during the examination? Select all that apply.
Cool skin Poor capillary refill
A nurse is assessing lab values for a client admitted to rule out myocardial infarction. Which test represents an isoenzyme of heart muscle?
Creatine kinase-MB (CK-MB)
What is an indication of air leaking into the subq tissues, indicating a chest tube may be compromised?
Crepitus
The nurse is assessing the chest tube insertion site of a client with a hemothorax of the right lower lobe. Which assessment finding would most concern the nurse?
Crepitus around the chest tube insertion site
Which questions should the nurse ask the client when assessing for peripheral vascular deficits? Select all that apply.
Do you have numbness in your hands and feet? Are there any sores on your legs that never heal? What makes the pain worse, elevating your legs or dangling them?
When is stridor heard?
During inspiration when there is a partial airway obstruction
Difficulty breathing
Dyspnea
Occurs when there are extra beats in the cardiac cycle
Ectopy
The nurse is reviewing the ECG strip and notes a U wave is present. What could be the cause?
Electrolyte imbalance
A nurse is reviewing clinical data on a client with a history of type 2 diabetes mellitus, hypertension, and tobacco use. What data is the most concerning?
Elevated CRP of 3.2 mg/dL
A community health nurse is teaching hands-only CPR for a single rescuer of an unwitnessed adult victim collapse. Put the steps in order.
Establish responsiveness Call 911 Obtain an AED Start CPR while waiting for the AED When the AED arrives, turn on, apply pads, and follow instructions Continue CPR until emergency help arrives
What should the nurse document in the health record for a client who has 14 unlabored respirations per minute?
Eupneic
The nurse is caring for a client with a chronic cough and shortness of breath. The client denies smoking but lives in "a house of smokers." What should the nurse include when teaching the client? Select all that apply.
Even small amounts of smoke cause damage to the vessels and abnormal heart rate Secondhand smoke leads to increased risk for stroke and increased death from cancer There is no safe level of exposure to secondhand smoke Smoke inhalation can lead to emphysema and COPD
How often should the nurse provide tracheostomy care?
Every 4 to 8 hours
The nurse is teaching a client with chronic obstructive pulmonary disease (COPD) about deep breathing exercises. Which aspect should the nurse include for this client?
Exhale slowly through pursed lips to avoid high expiratory pressures
What is the purpose of diuretics?
Increase the elimination of sodium and water from the body by increasing urinary output
An individual has recently moved from the coast of Florida to the Rocky Mountains in Colorado. What physiological changes will occur over time to facilitate oxygenation? Select all that apply.
Increased RBC production Increased lung volume and pulmonary vasculature Increased ventilation Arterial chemoreceptors stimulate ventilation
The nurse is caring for a client with a chest tube when the tube becomes disconnected from the drainage container. What action should the nurse take immediately?
Insert the tube into sterile water
A client presents with cyanosis, tachypnea, and grunting, and reports having difficulty breathing. What is the immediate action the nurse should take?
Inspect to observe respiratory patterns and signs of respiratory distress
Gas exchange that occurs between the body organs and tissues where O2 and CO2 are exchanged between capillary-cellular membranes is referred to as what type of respiration?
Internal
Cardiac dysrhythmias have the potential to decrease cardiac output. Which type of dysrhythmia is located in the AV node?
Junctional
The nurse is educating a client regarding the cardiovascular effects of chronic alcohol abuse. Which information should the nurse include? Select all that apply.
Leads to CHF Forms thrombi in the coronary arteries Depresses cardiovascular centers of the brain
Which diagnostic tests should the nurse expect the healthcare provider to prescribe to determine a client's risk for cardiovascular disease? Select all that apply.
Lipid panel Cholesterol level CRP
What does the P wave represent?
The firing of the SA node and conduction of the impulse through the atria
What does the T wave represent?
The return of ventricles to an electrical resting state so they can be stimulated again
A client is learning about anticoagulant therapy that inhibits thrombin in the clotting chain. Which statement indicates that the client understands this therapy?
There are antidotes for this medication
What is the purpose of statins?
To decease elevated LDL cholesterol levels
What is the purpose of vasodilators?
To dilate the vessels, which eases the work of the heart
What is the purpose of positive inotropes?
To increase cardiac contractility
In which position should the nurse place the client to perform percussion and postural drainage for the middle lung lobes?
Trendelenburg
Which cranial nerve receives sensation from the face and innervates the muscles of mastication?
Trigeminal nerve
When teaching a client how to use a peak flow meter at home, what should be done if the reading falls within the yellow marker of the meter?
Use a fast acting bronchodilator
The heart is regulated by the autonomic nervous system (ANS) and control centers in the brainstem. Where do the parasympathetic fibers innervate the heart?
Vagus nerve
Which cranial nerve is both a sensory and motor nerve in the heart?
Vagus nerve
A client reports to the emergency room with shortness of breath and chest pain. The healthcare provider suspects a pulmonary embolism. Which diagnostic test should the nurse anticipate?
Ventilation-perfusion scan
Cardiac dysrhythmias that occur within the ventricles
Ventricular
What should the nurse include when educating the parents of a toddler about safety hazards that can affect breathing? Select all that apply.
Water safety Choking on objects
Which of the following assessment findings would help confirm a diagnosis of asthma in a client?
Wheezing on inspiration and expiration
The nurse is administering morning medications, including a once-a-day aspirin to a client with cardiovascular disease and diabetes mellitus. The client asks the nurse why the healthcare provider prescribed an aspirin when they have no pain. What is the nurse's best response?
Your risk for heart attacks and strokes can be decreased by taking aspirin everyday
What does peak expiratory flow rate measure?
the amount of air that can be exhaled with forcible effort